HomeMy WebLinkAboutGREELEY - INSURANCE CERTIFICATEClient# 12170
GRECI
ACORD CERTIFICATE OF LIABILITY
INSURANCE DATE
1'"""°°"Y"'
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Paterson IDS Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P O BOX 578
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
1687 W 18th Street
Greeley CO 80632
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A Pmnacol Assurance
City Of Greeley
10001 Oth Street
Greeley CO 80631
INSURER B
INSURER C
INSURERD
NSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
mw LTR
TYPE OF INSURANCE
MUCY NUMBER
Po
110,100fM
AICY EXPIRATION TE fMLWDDNY)
POLDAM
LDnS
GENERAL UASILffY
COMAERCML GENERAL LIABILITY
CLAMS MADE F-IOCCUR
EACHOCCURRENCE
$
DAMAGE TO RENTED
$
MED EXP (Any ore I n)
$
PERSONALBADVINJURY
$
GENERAI.AGGREGATE
$
GENT AGGREGATE LIMIT APPLIES PER
POLICY PRD LOC
PRODUCTS COMP/OP AGG
$
AUTOMOBILE
LABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-0WNED AUTOS
COMBINED SINGLE OMIT
(Ee eeatleM)
$
BODILY INJURY
(Pw �)
$
BODILY INJURY
(Per ecdtlenU
$
PROPERTY DAMAGE
(Pere .t)
$
GARAGE LIABILITY
ANY AUTO
p
AUTOONLY EAACCIDENT
$
OTHER THAN EA AOC
AUTO ONLY AGG
$
$
EXCESSNNBRELLA
LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
A
waniuut6 CoiwNsimTION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOItPARTNER/EXECUTNE
OFFICERrMEMBER EXCLUDED'!
N yyee0.0. deernbe ender
SPECIAL PROVISIONS below
4025273
01/01/08
01/01/09
WCSTATNU OM -
X I
E L EACH ACCIDENT
E1OO OOO
EL DISEASE EAEMPLOYEE
$100000
E L DISEASE POLICY LIMIT
$500 000
O'nIER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
To Whom It May Concern
OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
IEREOF THE 188UlNfi INSURER eNLL ENDEAVOR TO MAR20 DAYS WRITTEN
TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
ACORD 25 (2001108) 1 Of 2 #S407629/M401676 DSM 0 ACORD CORPORATION 1988
U-U7ZICIM
If the cerbficate holder is an ADDITIONAL INSURED the polrcy(res) must be endorsed A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsements)
If SUBROGATION IS WAIVED subject to the terms and conditions of the policy certain policies may
require an endorsement A statement on this certficate does not confer rights to the certificate
holder in lieu of such endorsement(s)
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s) authorized representable or producer and the cerbfcate holder nor does it
affirmatively or negatively amend extend or after the coverage afforded by the policies listed thereon
ACORD 25S (2001108) 2 of 2 #S407629IM401676